KINGSTON, R.I. — Feb. 21, 2025 — Hispanic-Latino individuals experience some of the highest obesity rates in the U.S. compared to other ethnic groups, yet have far lower rates of metabolic and bariatric surgery (MBS), the most effective obesity treatment. A University of Rhode Island doctoral student’s study aims to find out why, identify socio-cultural factors, improve understanding of healthcare access in obesity care, and develop culturally relevant educational materials.

Obesity prevalence among Hispanic-Latino individuals stands at 45.6 percent, according to the federal Centers for Disease Control and Prevention, yet the group comprises less than 15 percent of MBS patients, compared to about 70 percent of non-Hispanic white individuals.

Viviane Fornasaro-Donahue, a registered dietitian at the Miriam Hospital and a doctoral candidate in behavioral psychology at URI, will speak directly with study participants recruited through community partners in Providence to understand their perspectives on obesity and obesity-related care. Fornasaro-Donahue aims to explore potential barriers to accessing treatment, and ultimately, help inform the community about available obesity treatment options to improve their health. Additionally, her findings may offer insights for providers on potential opportunities to enhance patient-provider communication regarding obesity.

“We want to hear directly from the community about their perceptions of obesity and obesity care,” Fornasaro-Donahue said. “Are there socio-cultural influences that shape their views on obesity and treatment? What do they think about available treatments, such as MBS and obesity medications? Do they have access to treatment and, if so, what factors influence their decision to choose MBS, pursue an alternative treatment, or forgo treatment altogether. How do the views of those seeking MBS differ from those who are not? What has been their experience discussing obesity and health with their healthcare providers? Does acculturation play a role? These are the questions we aim to answer.”

Funded by awards from the Society for the Psychological Study of Social Issues, The Miriam Hospital, and URI, the study will include two participant groups: individuals pursuing MBS and those with obesity who are not seeking surgical treatment. Through semi-structured interviews, researchers will analyze themes such as obesity bias, stigma, social-cultural beliefs, patient-provider communication, and healthcare accessibility in obesity care. Findings will help inform healthcare providers and lead to the development of culturally sensitive educational materials to be distributed in relevant communities.

The study highlights the effectiveness of MBS on treating obesity. The surgeries, which include gastric bypass and sleeve gastrectomy—work mainly by reducing the size of the stomach, and by altering the digestion process and gut hormone responses that regulate appetite, such as Ghrelin and GLP-1—are proven long-term treatments for obesity. Within one year of surgery, patients can expect to lose up to 80 percent of extra weight, and experience improvements in many obesity-related conditions, including Type 2 Diabetes, hypertension, cardiovascular disease, and sleep apnea. In comparison, anti-obesity medications can promote an average weight loss of 5 to 15 percent, while diet and exercise alone typically result in a 3-7 percent weight loss. Yet, despite its effectiveness, only about 1 percent of eligible individuals undergo the procedure, Fornasaro-Donahue said.

“Metabolic and bariatric surgeries aren’t just restrictive procedures—they have a hormonal impact that makes them the most effective long-term treatment for obesity, but they are underutilized,” Fornasaro-Donahue said. “Restrictive dieting to lose weight is a predictor for weight regain. This is in part because the body perceives restriction as starvation, and responds by trying to return to its original weight, which is set at a certain range. With bariatric surgery, some degree of weight recurrence is possible, however, most individuals maintain significant weight loss and health improvements compared to their pre-operative status. MBS is effective, it’s long-term, and provides incredible health benefits.

“This work will help providers improve communication about the surgeries’ benefits, empower patients, and encourage informed decisions about obesity treatment,” she continued. “We strive to inform people that obesity is not the individual’s fault. It is a condition influenced by multiple factors. By informing the public, providing supportive health care and access to resources, reducing stigma, and recognizing obesity as a chronic disease that requires effective treatment, we can help create better health outcomes for those affected.”